CHAPTER 12 Digestive System
Digestive System Overview Known as gastrointestinal tract Also known as digestive tract or alimentary canal Approximately 30 feet long Begins with mouth (oral cavity), ends with anus Functions Prepare foods for absorption into the bloodstream Prepare foods for use by the body cells Responsible for elimination of solid wastes from the body
Digestive System Structures Oral cavity (Buccal cavity) Lips Cheeks Hard palate Rugae Soft palate Uvula Tongue Principle organ of the sense of taste Also assists in process of chewing (mastication) and swallowing (deglutition)
Digestive System Structures Salivary glands Three pairs Parotids Submandibulars Sublinguals Secrete saliva Mostly water, but contains mucus and digestive enzymes that aid in digestive process Digestive enzymes contained in saliva Amylase – aids in digestion of carbohydrates Lipase – aids in digestion of fats
Digestive System Structures Pharynx Known as the throat Serves as passageway for both respiratory and digestive systems Oropharynx Section leading away from oral cavity Nasopharynx Behind nasal cavity Laryngopharynx Lower portion – opens into esophagus and larynx
Digestive System Structures Esophagus Receives food from pharynx and propels it to stomach Cardiac sphincter (lower esophageal sphincter) controls passage of food from esophagus into the stomach Relaxes = food enters stomach Contracts = stomach contents prevented from reentering the esophagus
Digestive System Structures Stomach Fundus Upper rounded portion Body Central part
Digestive System Structures Stomach Pylorus Lower tubular part (also called the gastric antrum) Pyloric sphincter regulates passage of food from stomach into the duodenum Folds in mucous membranes of stomach = Rugae
Digestive System Structures Stomach Gastric juices breakdown food in stomach Muscular action of stomach causes churning of food Mixes food with the secretions Chyme = liquidlike mixture of partially digested food and digestive secretions
Digestive System Structures Small intestine Approximately 20 feet long Also known as the small bowel Divided into three parts Duodenum Jejunum Ileum
Digestive System Structures Large intestine Cecum Appendix hangs from lower portion of cecum Ascending colon Hepatic flexure Transverse colon Splenic flexure Descending colon Sigmoid colon Rectum Anus
Accessory Organs of Digestion Liver Located immediately under diaphragm, slightly to the right Only digestive function Production of bile for emulsification of fats in small intestine
Accessory Organs of Digestion Liver Additional functions of liver Excretion of bile pigments into bile Synthesis of vitamin K-dependent plasma proteins Amino acid metabolism Carbohydrate metabolism Fat metabolism Phagocytosis Detoxification Storage of vital nutrients
Accessory Organs of Digestion Gallbladder Pear-shaped sac, located under surface of liver Main function: To store and concentrate bile produced by the liver Releases bile in response to presence of fatty content of food present in duodenum Emulsifies fats
Accessory Organs of Digestion Pancreas Located in upper left quadrant of abdomen, behind stomach Functions as exocrine gland to manufacture digestive juices Trypsin – breaks down proteins Pancreatic lipase – breaks down fats Pancreatic amylase – breaks down carbohydrates Sodium bicarbonate – neutralizes acidic stomach contents
Accessory Organs of Digestion Pancreas Functions as endocrine gland to manufacture insulin and glucagon Insulin – hormone that makes it possible for glucose to pass from blood through cell membranes to be used for energy Insulin also promotes conversion of excess glucose into glycogen Glucagon – hormone that stimulates the liver to convert glycogen into glucose in time of need
Accessory Organs of Digestion Teeth Primary responsibility Chewing (mastication) Food is ground by teeth and softened by saliva Primary teeth = deciduous teeth Set of 20 teeth – appears around age 6 months Secondary teeth = permanent teeth Begin to appear around age 6
Accessory Organs of Digestion Teeth Incisors Chisel shape with sharp edges for biting food Canine or cuspid teeth Useful for grasping and tearing food Bicuspids (premolars) and molars Flat surfaces, multiple projections for crushing and grinding food
Accessory Organs of Digestion Teeth Crown Visible part of the tooth Covered with enamel – hardest substance in body Neck Lies just beneath the gum line Root Embedded in bony socket of the jaw bone Root canal = pulp cavity Central core of the tooth
Accessory Organs of Digestion Layers of Teeth
Common Signs and Symptoms Achlorhydria Abnormal condition characterized by the absence of hydrochloric acid in the gastric juice Anorexia Lack or loss of appetite, resulting in the inability to eat
Common Signs and Symptoms Aphagia Condition characterized by the loss of the ability to swallow as a result of organic or psychologic causes Ascites Abnormal accumulation of fluid within the peritoneal cavity Fluid contains large amounts of protein and electrolytes
Common Signs and Symptoms Borborygmus An audible abdominal sound produced by hyperactive intestinal peristalsis Borborygmi are rumbling, gurgling, and tinkling noises heard when listening with a stethoscope
Common Signs and Symptoms Constipation Difficulty in passing stools, or an incomplete or infrequent passage of hard stools Diarrhea Frequent passage of loose, watery stools
Common Signs and Symptoms Dyspepsia Vague feeling of epigastric discomfort after eating Involves an uncomfortable feeling of fullness, heartburn, bloating, and nausea Dysphagia Difficulty in swallowing, commonly associated with obstructive or motor disorders of the esophagus
Common Signs and Symptoms Emaciation Excessive leanness caused by disease or lack of nutrition Emesis Material expelled from the stomach during vomiting Vomitus
Common Signs and Symptoms Eructation Act of bringing up air from the stomach with a characteristic sound through the mouth Belching Flatus; Flatulence Air or gas in the intestine that is passed through the rectum
Common Signs and Symptoms Gastroesophageal Reflux Backflow of contents of stomach into esophagus Often result of incompetence of the lower esophageal sphincter Icterus A yellowish discoloration of the skin, mucous membranes, and sclera of the eyes, caused by greater than normal amounts of bilirubin in the blood Also called jaundice
Common Signs and Symptoms Melena An abnormal, black, tarry stool containing digested blood Nausea Unpleasant sensation often leading to the urge to vomit Pruritus ani A common chronic condition of itching of the skin around the anus
Common Signs and Symptoms Steatorrhea Greater than normal amounts of fat in the feces Characterized by frothy, foul-smelling fecal matter that floats Vomit To expel the contents of the stomach through the esophagus and out of the mouth
PATHOLOGICAL CONDITIONS Digestive System
Achalasia Pronounced Defined (ak-al-LAY-zee-ah) Decreased mobility of the lower two-thirds of the esophagus along with constriction of the lower esophageal sphincter
Anal Fistula Pronounced Defined (AY-nal FISS-too-lah) Abnormal passageway in the skin surface near the anus usually connecting with the rectum May occur as the result of a draining abscess
Aphthous Stomatitis Pronounced Defined (AFF-thus stoh-mah-TYE-tis) Small inflammatory noninfectious ulcerated lesions occurring in the lips, tongue, and inside the cheeks of the mouth Also called canker sores
Appendicitis Pronounced Defined (ap-pen-dih-SIGH-tis) Inflammation of the vermiform appendix Usually an acute condition that can lead to rupture (perforation) with resultant inflammation of the peritoneum (peritonitis)
Celiac Disease Pronounced Defined (SEE-lee-ak disease) Nutrient malabsorption due to damaged small bowel mucosa
Cirrhosis Pronounced (sih-ROH-sis) Defined Disease of the liver that is chronic and degenerative causing injury to the hepatocytes (functional cells of the liver) Fat infiltrates lobules of the liver, causing tissue covering the lobes to become fibrous Functions of liver eventually deteriorate
Colorectal Cancer Pronounced Defined (koh-loh-REK-tal CAN-sir) Presence of a malignant neoplasm in the large intestine
Constipation Pronounced Defined (kon-stih-PAY-shun) A state in which the individual’s pattern of bowel elimination is characterized by a decrease in the frequency of bowel movements and the passage of hard, dry stools Individual experiences difficult defecation
Crohn’s Disease Pronounced Defined (KROHNZ dih-ZEEZ) Digestive tract inflammation of a chronic nature causing fever, cramping, diarrhea, weight loss, and anorexia
Dental Caries Pronounced Defined (DEN-tal KAIR-eez) Tooth decay caused by acid-forming microorganisms
Dysentery Pronounced Defined (DISS-en-ter-ee) A term used to describe painful intestinal inflammation typically caused by ingesting water or food containing bacteria, protozoa, parasites, or chemical irritants Person has frequent stools that often contain blood
Diverticular Disease Pronounced Defined (dye-ver-TIK-yoo-lar dih-ZEEZ) Expression used to characterize both diverticulosis and diverticulitis Diverticulosis = non-inflamed outpouchings or herniations of the muscular layer of the intestines, typically the sigmoid colon Diverticulitis = inflammation of these outpouchings
Esophageal Varices Pronounced Defined (eh-soff-ah-JEE-al VAIR-ih-seez) Swollen, twisted (tortuous) veins located in the distal end of the esophagus
Gallstones (Cholelithiasis) Pronounced (koh-lee-lih-THIGH-ah-sis) Defined Pigmented or hardened cholesterol stones formed as a result of bile crystallization
Hemorrhoids Pronounced Defined (HEM-oh-roydz) Hemorrhoid is an unnaturally distended or swollen vein (varicosity) in distal rectum or anus
Hepatitis Pronounced Defined (hep-ah-TYE-tis) Acute or chronic inflammation of the liver due to a viral or bacterial infection, drugs, alcohol, toxins, or parasites
Hernia Pronounced Defined (HER-nee-ah) Irregular protrusion of tissue, organ, or a portion of an organ through an abnormal break in the surrounding cavity’s muscular wall
Herpetic Stomatitis Pronounced Defined (her-PEH-tic stoh-mah-TYE-tis) Inflammatory infectious lesions in or on the oral cavity occurring as a primary or a secondary viral infection caused by herpes simplex
Hirschsprung’s Disease (Congenital Megacolon) Pronounced (HIRSH-sprungz dih-ZEEZ) (kon-JEN-ih-tal meg-ah-KOH-lon) Defined Absence at birth of the autonomic ganglia in a segment of the intestinal smooth muscle wall that normally stimulates peristalsis
Ileus Pronounced Defined (ILL-ee-us) Obstruction of the intestine May occur due to twisting of the bowel, absence of peristalsis, or presence of adhesions or tumor
Intestinal Obstruction Pronounced (in-TESS-tin-al ob-STRUCK-shun) Defined Complete or partial alteration in the forward flow of the contents in the small or large intestines
Intussusception Pronounced Defined (in-tuh-suh-SEP-shun) Telescoping of a portion of proximal intestine into distal intestine usually in the ileocecal region causing an obstruction Typically occurs in infants and young children
Irritable Bowel Syndrome Spastic Colon Pronounced (EAR-it-ah-b’l BOW-el SIN-drom) (SPAS-tik COH-lon) Defined Increased motility of the small or large intestinal wall resulting in abdominal pain, flatulence, nausea, anorexia, and the trapping of gas throughout the intestines
Oral Leukoplakia Pronounced Defined (OR-al loo-koh-PLAY-kee-ah) Precancerous lesion occurring anywhere in the mouth
Pancreatitis Pronounced Defined (pan-kree-ah-TYE-tis) Acute or chronic destructive inflammatory condition of the pancreas May be acute or chronic
Peptic Ulcers (Gastric, Duodenal, Perforated) Pronounced (PEP-tik ULL-sir) (GAS-tric, doo-oh-DEE-nal, PER-foh-ray-ted) Defined Break in the continuity of the mucous membrane lining of the gastrointestinal tract as a result of hyperacidity or the bacterium, Helicobacter pylori
Peptic Ulcers Peptic ulcer descriptions Symptoms of an ulcer Acute or chronic Singular or clustered Shallow or deep Symptoms of an ulcer Gnawing epigastric pain Heartburn or indigestion Nausea and vomiting Bloated feeling after eating
Periodontal Disease Pronounced Defined (pair-ee-oh-DON-tal dih-ZEEZ) Group of inflammatory gum disorders May lead to degeneration of teeth, gums, and sometimes surrounding bones
Polyps, Colorectal Pronounced Defined (PALL-ips koh-loh-REK-tal) Small growths projecting from the mucous membrane of the colon or rectum May be sessile (attached by a base) or pedunculated (attached by a stalk) May vary in size and may be benign or pre-cancerous
Thrush Pronounced Defined (THRUSH) Fungal infection in the mouth and throat producing sore, creamy white, slightly raised curdlike patches on the tongue and other oral mucosal surfaces Caused by Candida albicans
Ulcerative Colitis Pronounced Defined (ULL-sir-ah-tiv koh-LYE-tis) Chronic inflammatory condition resulting in a break in the continuity of the mucous membrane lining of the colon in the form of ulcers Characterized by large watery diarrheal stools containing mucus, pus, or blood
Volvulus Pronounced Defined (VOL-vyoo-lus) Rotation of loops of bowel causing a twisting on itself that results in an intestinal obstruction